HomeMy WebLinkAboutG L HOFF - INSURANCE CERTIFICATEClient#: 24740
GLHOF
ACORD- CERTIFICATE OF LIABILITY INSURANCE
DAT
12/181060nvrr)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: St. Paul Travelers Insurance Company
G.L. Hoff Company
INSURER B: Pinnacol Assurance
1815 W 12th Street; P.O. Box 7448
Loveland, CO 80537
INSURER C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN3R
LTR
ADD
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM DD
POLICY EXPIRATION
DATE MWDDnY
LIMBS
A
GENERAL LIABILITY
DTC0325D6515TIL07
01/01/07
03/01/07
EACH OCCURRENCE
$1000000
OMGENERAL LIABILITY
Cncel
DAMAGE TO REN
TEDMERCIAL
$300 000
CLAIMS MADE 51OCCUR
MED EXP (Any one person)
$j 00Q
PERSONAL &ADV INJURY
$1 00Q 000
X PCDed:2,500
GENERAL AGGREGATE
S2,000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2 00Q 000
POLICY PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT810325D6515TIL07 .-`'
' a10V07,
�� ! Y
03101J0#
r q
'N' I�
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,D0D
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
-
HIREDAUTOS
NON-OWNEDAUTOS
-
zoos
X
BODILY INJURY
(Per accident)
$
X
RISK
MANAGEMENT
•�.ULL INS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS/UMBRELLALIABILITY
_X1 OCCUR 7 CLAIMS MADE
DTSMCUP325D6515TIL
01/01/07
03/01/07
EACH OCCURRENCE
$1 000000
AGGREGATE
$1 00Q 000
DEDUCTIBLE
X RETENTION $ 10000
$
B
WORKERS COMPENSATION AND
2242590
01/01/07
01/01/08
X WC LIMIT 1 0rR
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$500,000
A
OTHER
QT6606062BO90TIL07
01/01/07
03/01/07
Limit $1,000,000
Builders Risk
Deductible $1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is named as additional insured as their interest
may appear in regards to the operations of the named insured. (Excluding
Workers' Compensation) Bond Renewal
City of Fort Collins
Bond Renewal
P.O. Box 580
Fort Collins, CO $0522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'AD_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PrY Vr " tCYY "0) 1 oT [ FFM366994 TJR 0 ACORD CORPORATION 1988
ACORD. CERTIFICATE OF LIABILITY INSURANCE �2/18/06D"Y""'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: St. Paul Travelers Insurance Company
G.L. Hoff Company INSURER B: Pinnacol Assurance
1815 W 12th Street; P.O. Box 7448 INSURER C:
Loveland, CO 80537
INSURER D:
INSURER E:
rnucoer_oc
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE IMM CY EFFECTIVE
DATE EXPIRATION
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51OCCUR
X PD Ded:2,500
DTC0325D6515TIL07
01/01/07
03/01/07
EACH OCCURRENCE
$1 000 000
DAMAGE TO RPREmis ENTED
$300 000
MED EXP (Any one person)
$5 000
PERSONAL&ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
DT810325D6515TIL07
CITY
01/01/07
ft :,1e ,
ei
- - -
Of :'uit i
03/01/07_ _
r' d
� 11yy.�,
Jy.p
06
uLLINS
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROP ciTY DAMAGE
(PeGARAGE
$
LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLALIABILITY
X1 OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
DTSMCUP32SD6515TIL
01/01/07
03/01/07
EACH OCCURRENCE
$1000000
AGGREGATE
$1 000 000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
SPECIAL Pribe under ROVISIONS below
2242590
01/01/07
01/01/08
X WC STATU- CT" -
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE-EAEMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
A
OTHER
Builders Risk
QT6606062BO90TIL07
01/01/07
03/01/07
Limit $1,000,000
Deductible $1,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Pedestrian Bridges
Certificate holder is named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
Workers' Compensation).
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _30_ DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED
AUUKL/ 25 jZUUT/UU) 1 of 2 #M366994 TJR 0 ACORD CORPORATION 1988
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/18/06DNYYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 270370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: St. Paul Travelers Insurance Company
G.L. Hoff Company INSURER B: Pinnacol Assurance
1815 W 12th Street; P.O. BOX 7448 INSURER C:
Loveland, CO 80537 INSURER D:
INSURER E:
GUVIzKAGtJ
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN58
LTR
ROD'
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDffYI
POLICY EXPIRATION
DATE jKMjPDrM
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE F—X] OCCUR
X PD Ded:2,500
DTC0325D6515TIL07
01/01/07
03/01/07
EACH OCCURRENCE
$1 000 000
DAMAGE TO RENTPREMISE (E...ED
$300 000
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$2 000 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
DT810325D6515TIL07
01/01/07
03/01/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000 ,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLALIABILITY
X1 OCCUR I I CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
DTSMCUP325D6515TIL
01/01/07
03/01/07
EACH OCCURRENCE
$1 000000
AGGREGATE
$1 000 000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
2242590
01101/07
01/01/08
X WC STATU- OTH-
PR
E.L. EACH ACCIDENT
$5001000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
s500,000
A
OTHER
Builders Risk
QT6606062B090TIL07
01/01/07
03/01/07
Limit $1,000,000
Deductible $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Bid #5878 Pedestrian Bridge and Abutments
City of Fort Collins
Attn: John Stephen
215 N. Mason St., Second Floor
PO Box 580
Fort Collins, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED
^.. ..'� t'w rrvu/ T OT L 4111135W394 TJR 0 ACORD CORPORATION 1988